Retraction of the upper eyelid. Ptosis of the upper eyelid: what causes it and how to deal with it? Blepharoptosis of the upper eyelid after blepharoplasty

Ptosis of the upper eyelid can cause inconveniences such as eye fatigue and external defects, or it may not be felt at all, and even outwardly be almost invisible. What causes it and how to deal with ptosis of the upper eyelid - we will consider in this article.

Hello dear! Svetlana Morozova is with you. Today, I will talk about the drooping of the eyelid. What are the features of the onset and development of ptosis, how it is treated with and without surgery, is it possible to get rid of ptosis at home on your own - read these and many other interesting facts below.

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Upper eyelid ptosis: highlights

With ptosis, the eyelid border falls below the normal level. This happens when the nerve is damaged, when the nerve signals from the brain are interrupted at some stage and do not reach the eye muscle.

There are 3 degrees of severity of ptosis:

1 degree (partial) - closed ⅓ of the pupil;
Grade 2 (incomplete) - from half to ⅔ of the pupil is closed;
Grade 3 (complete) - the pupil is completely closed by the eyelid.

In this case, both one eyelid and both can be omitted. In the first degree, no discomfort may be felt, but the remaining 2 are accompanied by the following symptoms:

It becomes hard to blink.
The eye does not close completely, so the mucous membrane dries, irritation develops.
There is a feeling of sand in the eyes, pain.
Often there is conjunctivitis.
Sometimes the mucous border of the eyelid is everted.
Due to muscle strain, the eyes and head can hurt.
In advanced cases, vision is impaired, double vision, strabismus develops.
With neurogenic ptosis, there is a retraction of the eyeball and a change in the size of the pupil.

It happens that ptosis is confused with pseudoptosis. Outwardly, it may look the same, but the development mechanism is different - the eye narrows due to muscle spasm (nervous tic). Also, ptosis can be confused with folds on the eyelid, which some people develop with age. The so-called gravitational ptosis.

By the way, the eyelid is not the only thing that can be affected by ptosis. There are also:

Ptosis of the mammary glands (mastoptosis);
Ptosis of the buttocks;
Ptosis of internal organs (intestines, stomach, kidneys, etc.)

Any relaxation of muscle structures and the omission of them or those organs that they fix is called ptosis in medicine.

Why does ptosis develop?

For reasons, ptosis of the upper eyelid is divided into 2 groups: congenital and acquired. Let's take a look in more detail.

Purchased:

Neurogenic. Ptosis occurs due to paralysis after some diseases of the nervous system: stroke, meningitis, neuritis, cerebral ischemia, multiple sclerosis, abscess, CNS tumors, Horner's syndrome, encephalitis, diabetes mellitus.
Aponeurotic. Here the eyelid droops due to the fact that the muscles of the eyelid are stretched or parted. This usually happens due to aging.
Mechanical. In this case, ptosis develops due to trauma to the eye or eyelid, scars or tears in the eye tissues, foreign particles in the mucous membrane of the eye. Or because of the displacement of the eyeball by the tumor.
Myogenic. The cause of ptosis here is myasthenia gravis - a chronic weakening of the muscles. There is a temporary myasthenia gravis and after an unsuccessful plastic surgery of the face. For example, ptosis is one of the possible complications. It can last up to a month.

Congenital:

Pathology in the development of the levator eyelid muscle.
Strabismus.
Violation of the facial or oculomotor nerves.
Blepharomimosis is a too narrow slit of the eye due to the eyelids fused at the corners.
Excess skin on the eyelids.

Any of these causes are aggravated by poor blood circulation, hypertonicity and spasms of the facial muscles, weak lymph flow, any chronic inflammation, improper facial skin care, and failure to perform regular facial exercises. All these factors accelerate aging and degenerative processes in the body.

Diagnosis of ptosis

An ophthalmologist determines ptosis, and then, depending on the causes, prescribes treatment. To do this, you need to go through a number of diagnostic measures:

Measurement of the vertical size of the eyelids, determination of their symmetry at rest and when blinking;
Determination of muscle tone (electromyography);
Detection of strabismus;
Autorefractometry - measurement of the optical capabilities of the eye;
Determination of visual acuity and fields;
Examination of the cornea for dystrophy or lesions;
Estimation of tear fluid volume;
X-ray of the eye socket;
ultrasound of the eye;
MRI of the brain;
The conclusion of the neurologist.

In children, the diagnosis is carried out in a special way. First of all, it is determined whether there is amblyopia (decreased vision) - in this case, ptosis must be urgently treated.

Treatment of ptosis is surgical and conservative, that is, without surgery. Let's start with the conservative.

What to do to cure ptosis of the upper eyelid without surgery

Non-surgical treatment is prescribed less frequently than surgery. At grade 1 ptosis, it can help cure eyelid prolapse completely, and at grades 2 and 3, it can stop the progression in anticipation of surgery and after. This includes several methods:

Hardware treatment: UHF-therapy (impact on the nerve with high-frequency electromagnetic waves), galvanotherapy (exposure to galvanic current);
Drug treatment: taking drugs to nourish the nervous tissue; instillation of drops to stimulate eyelid contraction; the introduction of drugs by injection (mesotherapy), including hyaluronic acid and Botox.
Treatment at home: special eyelid massage (both with the help of a specialist and on your own at home), strengthening compresses from decoctions and herbal infusions, applying tightening masks and creams, wiping the eyelid with cosmetic ice.

For treatment at home, it is imperative to perform special therapeutic exercises. Everyone knows that, for example, the prolapse of the mammary glands goes away after doing exercises for the chest, or the buttocks are tightened by a special fitness complex. However, many people forget about gymnastics for the eyelids, although this is especially necessary, because with ptosis, the blood supply to the tissues is already disturbed.

Here is an approximate set of exercises to eliminate the impending century:

Open your eyes wide, rotate your eyeballs. Then move them up and down and left and right.
Open your eyelids as wide as possible, stay in this position for 5 seconds, then close your eyes with force, also for 5 seconds.
Open your mouth, look up. Now blink fast.
Place your index fingers at the outer corners of your eyes. Slightly pull the skin to the sides, at the same time look up, overcoming resistance.

In the course you will find effective exercises for drooping eyelids, as well as for tightening all facial muscles.

Special exercises will help stop the progression of ptosis and even avoid surgery. In the photo before and after regular gymnastics, a difference is noticeable even at stages 2 and 3 of eyelid drooping.

This is the most common treatment for ptosis of the upper eyelid. For this, blepharoplasty is performed:

Anesthesia is being given. Adults - local, children - general anesthesia.
A section of skin is removed from the eyelid and the orbital septum is cut.
The main stage of the operation: in case of congenital ptosis, the muscle itself is shortened with sutures; when acquired, the aponeurosis is cut and sutured to the cartilage of the eyelid.
A cosmetic suture is applied with thin threads and a bandage on top.

It all takes about an hour. In Russia, the average cost of eyelid surgery ranges from 20-50 thousand rubles.

In some cases, there are contraindications for the operation:

Hypertension;
Any inflammatory processes in the body;
Violation of skin clotting;
Diabetes;
Cardiovascular diseases;
Pathology of the kidneys;
Endocrine failures;
Pregnancy, breastfeeding period;

I suggest everyone who is concerned about their appearance to turn to my course. I carefully selected a set of exercises and tested it on myself. Doing just 5-10 minutes a day, you can not only correct the oval, but also get rid of bruises and bags under the eyes, enlarged pores and acne, stimulate metabolic processes and get a blooming look.

That, perhaps, is all about what ptosis of the upper eyelid is and how to remove it yourself and with the help of surgery.

Share your feedback on the treatment of ptosis in the comments. Tell your friends about the article on social networks and do not forget to subscribe to blog updates.

Ptosis - drooping of the upper eyelid from barely noticeable to complete closure of the palpebral fissure. Ptosis is quite common, both in adults and in children.

1 - no crease of the upper eyelid
2 - the upper eyelid does not rise completely

The child has moderate congenital ptosis on the left - the upper eyelid is lowered, there is no fold of the skin of the eyelid, when looking up, the insufficiency of the muscle that lifts the eyelid is visible

Ptosis can be congenital or acquired.

Congenital ptosis occurs due to underdevelopment of the muscle that lifts the upper eyelid (levator), or a violation of its innervation associated with hereditary genetic abnormalities or pathology of pregnancy and childbirth. Congenital ptosis in a large percentage of cases is combined with other anomalies of the organ of vision: strabismus, amblyopia, anisometropia, etc.

Acquired ptosis, depending on the cause of its cause, is divided into:

aponeurotic - associated with stretching or weakening of the aponeurosis of the muscle that lifts the upper eyelid. This includes senile (involutional) ptosis as a manifestation of the natural aging process of the body; ptosis that occurred after ophthalmic operations and injuries of the levator aponeurosis

The palpebral fissure of the left eye is covered by the upper eyelid to the middle of the pupil, which is associated with stretching of the aponeurosis of the muscle that lifts the upper eyelid

neurogenic - when the nervous system is damaged as a result of any diseases or injuries (multiple sclerosis, the consequences of a stroke, etc.) Ptosis can develop, for example, with paralysis of the cervical sympathetic nerve, since the muscle innervated by the sympathetic nerve is involved in lifting the eyelid. In this case, simultaneously with the drooping of the upper eyelid, retraction of the eyeball (enophthalmos) and narrowing of the pupil (miosis) are observed. This symptom complex is called Horner's syndrome.
mechanical ptosis - occurs when the eyelid is deformed by scars, tears, foreign bodies

Mechanical ptosis of the upper eyelid is caused by the growth of a neoplasm on the upper eyelid, which, under the force of gravity, does not allow it to occupy the correct position.

apparent (false) ptosis - with excessive skin folds of the upper eyelid (blepharochalasis), with severe hypotension of the eyeball, ptosis with strabismus

In this example, excess skin folds and hangs over the upper eyelids of both eyes, giving the impression of ptosis.

Ptosis can be unilateral or bilateral.

According to the degree of expression, they distinguish:

partial ptosis - the edge of the upper eyelid is located in the upper third of the pupil;
incomplete ptosis - the edge of the upper eyelid reaches the middle of the pupil;
complete ptosis - the upper eyelid completely closes the pupil.

Ptosis is not only a cosmetic defect

With ptosis, the mobility of the upper eyelid may be reduced or completely absent. The lowered upper eyelid mechanically complicates vision, therefore, the usual position of raised eyebrows arises, in severe cases, especially in children, a forced position develops: the head is raised, the forehead is wrinkled - the so-called "stargazer's head". Ptosis in children prevents the normal development of the visual analyzer, contributing to the development of amblyopia (“lazy” eye) and strabismus, narrowing of the visual fields. Depending on the severity of eyelid drooping, one or another degree of visual impairment is noted.

1 - forehead wrinkling
2 - the eyebrow is constantly raised

Among other manifestations of ptosis, one can note such as: irritation of the eyes, fatigue due to constant muscle tension, there may be double vision. If ptosis is accompanied by the inability to completely close the eyes, then dry eye symptoms, chronic conjunctivitis and keratitis are observed.

In rare forms of ptosis, there may be other symptoms. For example, with Marcus-Gunn syndrome, ptosis disappears when the mouth is opened, the jaws are firmly clenched.

Diagnostics

In the diagnosis of ptosis, the establishment of the cause of this condition is of decisive importance. It is important to distinguish congenital eyelid ptosis from acquired, because the method of surgical treatment depends on this. Congenital ptosis is often combined with paresis of the superior rectus oculomotor muscle, sometimes with epicanthus (semilunar skin fold covering the inner corner of the eye). It should be clarified whether cases of ptosis or any other congenital pathologies were observed in relatives.

On examination, the position of the upper eyelid relative to the pupil, the mobility of the eyelid, the presence and size of the skin fold of the upper eyelid are assessed. Also evaluate the symmetry of the position of the eyes and the completeness of their movements, the mobility of the eyebrows. A standard ophthalmological examination is carried out: determination of visual acuity, measurement of intraocular pressure, examination of all structures of the eye. If necessary, instrumental diagnostic methods are used: for example, magnetic resonance imaging (MRI) for suspected multiple sclerosis, brain neoplasms, hematomas, etc. After injuries, radiography or computed tomography of the orbit is performed.

It is also necessary to consult a neurologist.

Ptosis treatment

Treatment of ptosis - in the vast majority of cases - surgical. Tightening the upper eyelid with adhesive tape while awake can be used as a temporary measure to prevent amblyopia and strabismus from developing in children before surgery can be performed. With neurogenic ptosis, the underlying disease is treated, local UHF therapy, galvanization, paraffin therapy, and in the absence of an effect, surgical correction of ptosis.

In case of congenital ptosis, the operation is aimed at shortening the muscle that lifts the upper eyelid, and in the case of acquired ptosis, at shortening the stretched aponeurosis of this muscle.

With acquired ptosis on the upper eyelid, a thin strip of skin and part of the aponeurosis of the muscle that lifts the upper eyelid is removed, the aponeurosis is thus shortened, pulling the muscle along with it, and the upper eyelid rises.

When correcting congenital ptosis, a small strip of skin is also removed, then the muscle that lifts the upper eyelid is isolated, on which several stitches are applied to shorten it. In cases of severe congenital ptosis of the eyelids, the levator eyelid muscle can be sutured to the frontalis muscle.

The sutures from the skin of the eyelids are removed on the third or fifth day after the operation. The results of surgical treatment are favorable - the effect, with a sufficient degree of shortening of the aponeurosis or muscle, as a rule, persists for almost a lifetime.

It must be understood that ptosis in children is not only a cosmetic defect, but also the cause of serious complications, such as strabismus and amblyopia. In adults, long-term ptosis can also cause a decrease in visual function, in addition, unexpectedly appearing drooping of the eyelid can signal certain diseases, therefore, even with the appearance of moderate asymmetry between the eyelids, it is necessary to consult an ophthalmologist. Children with ptosis should undergo surgical treatment on time.

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Ptosis of the eyelid, or blepharoptosis, is the drooping of the upper eyelid in relation to the edge of the iris by more than 2 mm. It is not only a cosmetic defect, but can be a symptom of a certain pathology and lead, especially in children, to a persistent decrease in visual acuity.

Symptoms and classification of ptosis of the occurrence of ptosis of the upper eyelid

The main symptoms are:

visually noticeable directly blepharoptosis;
sleepy facial expression (with bilateral lesions);
the formation of forehead skin wrinkles and a slight raising of the eyebrows when trying to compensate for ptosis;
rapid onset of eye fatigue, a feeling of discomfort and soreness with a load on the organs of vision, excessive tearing;
the need to apply effort to close the eyes;
over time or immediately occurring strabismus, decreased visual acuity and double vision;
"stargazer's posture" (slight tilting of the head backwards), which is especially characteristic of children and is an adaptive reaction aimed at improving vision.

The mechanism of development of this symptomatology and directly the ptosis itself is as follows. The motor functioning of the eyelid and the width of the palpebral fissure depend on the tone and contractions:

Levator of the upper eyelid (levator muscle), which controls the vertical position of the latter;
The circular muscle of the eye, which allows you to steadily and quickly close the eye;
The frontal muscle, which contributes to the contraction, compression of the eyelid with a maximum gaze upward.

Tone and contraction are carried out under the influence of nerve impulses coming to the circular and frontal muscles from the facial nerve. Its nucleus is located in the brainstem on the corresponding side.

The muscle that lifts the upper eyelid is innervated by a group of neurons (right and left bundles of the central caudal nucleus), which are part of the nucleus of the oculomotor nerve, also located in the brain. They go to the muscles of their own and the opposite side.

Video: Ptosis of the upper eyelid

Ptosis classification

It can be bilateral and unilateral (in 70%), true and false (pseudoptosis). False ptosis is caused by excess volume of the skin and subcutaneous tissue, hernia of the eyelid, strabismus, decreased elasticity of the eyeballs and, as a rule, is bilateral, with the exception of unilateral endocrine pathology of the eye.

In addition, a distinction is made between physiological and pathological drooping of the eyelids. The above groups of nerves are associated with the sympathetic nervous system, with the retina, with the hypothalamus and other brain structures, as well as with the frontal, temporal and occipital regions of the cerebral cortex. Therefore, the degree of muscle tone and the width of the palpebral fissure in the physiological state are in close relationship with the emotional state of a person, fatigue, anger, surprise, reaction to pain, etc. Blepharoptosis in this case is bilateral and is intermittent, relatively short-lived.

Pathological ptosis occurs with injuries or inflammatory processes of the eyeball or muscles that move the eyelid, with inflammatory processes of the meninges and with disorders at various levels (nuclear, supranuclear and hemispheric) in the conduction nervous system with heart attacks and brain tumors, disorders of sympathetic innervation and transmission of a nerve impulse to the muscles, with damage to the upper roots of the spinal cord, lesions of the brachial plexus (plexopathy), etc.

Depending on the degree of the pathological condition, there are:

Partial ptosis, or I degree, in which 1/3 of the pupil is covered by the upper eyelid.
Incomplete (II degree) - when half or 2/3 of the pupil is covered.
Full (III degree) - complete covering of the pupil.

Depending on the cause, blepharoptosis is divided into:

Congenital.
Acquired.

congenital pathology

Congenital ptosis of the upper eyelid occurs:

With congenital Horner's syndrome, in which ptosis is combined with pupillary constriction, dilation of conjunctival vessels, weakening of sweating on the face and a barely noticeable deeper location of the eyeball;
With Marcus-Hun syndrome (palpebromandibular synkinesis), which is a drooping eyelid that disappears during opening of the mouth, chewing, yawning or displacement of the lower jaw in the opposite direction. This syndrome is a consequence of a congenital pathological connection between the nuclei of the trigeminal and oculomotor nerves;
With Duane's syndrome, which is a rare congenital form of strabismus, in which there is no ability to move the eye outward;
As an isolated ptosis due to the complete absence or abnormal development of the levator or its tendon. This congenital pathology is very often inherited and is almost always bilateral;
With congenital myasthenia gravis or anomalies of the innervation of the levator;
Neurogenic etiology, in particular with congenital paresis of the third pair of cranial nerves.

Video: Congenital ptosis of the upper eyelid in children

Congenital ptosis of the upper eyelid in children

Acquired ptosis

Acquired ptosis, as a rule, is unilateral in nature and develops most often as a result of injuries, age-related changes, tumors or diseases (stroke, etc.), which result in paresis or paralysis of the levator.

Conventionally, the following main forms of the acquired pathological condition are distinguished, which can also be of a mixed nature:

aponeurotic

The most common cause is involutional age-related drooping of the upper eyelid as a result of dystrophic changes and weakness of the muscular aponeurosis. Less commonly, the cause may be traumatic injury, long-term treatment with corticosteroid drugs.

myogenic

Occurs usually with myasthenia gravis or myasthenic syndrome, muscular dystrophy, blepharophimosis syndrome, or as a result of ocular myopathies.

neurogenic

It occurs mainly as a result of violations of the innervation of the oculomotor nerve - with the syndrome of aplasia of the latter, its paresis, Horner's syndrome, multiple sclerosis, stroke, diabetic neuropathy, intracranial aneurysms, ophthalmoplegic migraine.

In addition, neurogenic ptosis also occurs when the sympathetic pathway is damaged, which begins in the hypothalamic region and the reticular formation of the brain. Blepharoptosis associated with damage to the oculomotor nerve is always combined with pupil dilation and impaired eye movement.

Violation of the transmission of impulse from the nerve to the muscle often occurs like its counterparts (Dysport, Xeomin) in the upper third of the face. In this case, blepharoptosis may be associated with impaired fun

the action of the eyelid itself as a result of the diffusion of the toxin into the levator. However, most often this condition develops as a result of local overdose, penetration or diffusion of the substance into the frontalis muscle, its excessive relaxation and aggravation of overhanging skin folds.

Mechanical

Or completely isolated ptosis due to inflammation and edema, isolated lesion of the levator, scarring, pathological process in the orbit, for example, a tumor, damage to the anterior part of the orbit, unilateral atrophy of the muscles of the face, for example, after a stroke, a significant tumor formation of the eyelid.

Blepharoptosis of the upper eyelid after blepharoplasty

It can be in the form of one of the listed forms or their combination. It occurs as a result of postoperative inflammatory edema, damage to the outflow tracts of the intercellular fluid, as a result of which its outflow is disturbed and tissue edema develops, damage to the muscles or muscle aponeurosis, as well as hematomas that limit their function, damage to the endings of the nerve branches, the formation of coarse adhesions.

How to treat this pathological condition?

Acquired ptosis of the upper eyelids

There are conservative methods of treatment and various surgical techniques. Their choice depends on the cause and severity of the pathology. As a very short-term auxiliary method, correction of the ptosis of the upper eyelid by fixing the latter with an adhesive plaster can be used. This method is used mainly as a temporary and additional one, when it is necessary to eliminate complications in the form of inflammation of the conjunctiva, as well as in case of complications after botulinum therapy.

Treatment of ptosis of the upper eyelid after Botox, Dysport, Xeomin

It is carried out by introducing prozerin, taking increased doses of vitamins “B 1” and “B 6” or administering them in solutions by injection, performing physiotherapy (electrophoresis with a solution of prozerin, darsonval, galvanotherapy), laser therapy, massage of the upper third of the face. At the same time, all these measures only slightly contribute to the restoration of muscle function. Most often it occurs on its own within 1-1.5 months.

Non-surgical therapy

Treatment of ptosis of the upper eyelid without surgery is also possible with false blephroptosis or, in some cases, a neurogenic form of this pathological condition. Correction is carried out in physiotherapy rooms through the use of the above physiotherapy and massage. Treatment at home is also recommended - this is massage, gymnastics to increase tone and strengthen the muscles of the upper third of the face, lifting cream, lotions with infusion of birch leaves, with a decoction of parsley root, with potato juice, processing with ice cubes with infusion or decoction of appropriate herbs.

Gymnastic exercises for ptosis of the upper eyelid are:

circular eye movement, look up, down, right and left with a fixed head;
the maximum possible opening of the eyes for 10 seconds, after which it is necessary to close the eyes tightly and tighten the muscles for 10 seconds as well (repeat the procedure up to 6 times);
repeated sessions (up to 7) of fast blinking for 40 seconds with the head thrown back;
repeated sessions (up to 7) of lowering the eyes with the head thrown back with a delay in looking at the nose for 15 seconds and followed by relaxation, and others.

It should be noted that all conservative methods of treatment are mainly not curative, but preventive. Sometimes, in the first degree, with the above forms of blepharoptosis, conservative therapy only slightly improves or slows down the progression of the process.

In all other cases of the pathological condition and with blepharoptosis II or III degree, it is necessary to use surgical methods.

A common disease - ptosis of the upper eyelid, can appear at any age for a variety of reasons.

This inevitably affects the quality and visual acuity, so it is imperative to deal with this disease.

What is ptosis and how to eliminate it using the methods of modern medicine will tell you our article.

What is ptosis of the upper eyelid

In medical terminology ptosis - a change in the location of organs (omission) relative to normal values.

Diagnose the disease is very simple, it is enough to conduct a personal examination of the patient. Normally, the upper eyelid covers the edge of the iris by approximately 1.5 mm.

If this indicator exceeds 2 mm, ptosis of the upper eyelid may occur. Learn about internuclear ophthalmoplegia.

Types (unilateral and bilateral) and degrees

This disease is classified into unilateral and bilateral, depending on whether there is a pathology in one eye, or whether it has spread to both at once.

From how much the eyelid is lowered, we can talk about complete or partial ptosis. According to the nature of the occurrence of the disease, congenital and acquired ptosis are distinguished.

The degree of manifestation of the disease:

First degree characterized by drooping of the eyelid by ⅓.
At the second degree there is a decrease of about ⅔.
Third degree determined when the eyelid is completely closed.

Often other diseases are confused with ptosis, for example, excessive overhanging of the skin of the eyelids.

Such changes often occur in old age and are usually bilateral in nature. With paralysis of the facial nerves, it is also possible to diagnose symptoms similar to ptosis, therefore, when contacting an ophthalmologist, additional consultation with a neurologist may be required.

In the picture: types of ptosis

Causes of occurrence, if one eye dropped

Depending on the diagnosis of the causes that led to such an ailment, the treatment is determined.

In children most often, the congenital form of ptosis is diagnosed, when symptoms are observed immediately after birth.
There may be several causes, starting from hereditary factors and ending with pathologies of the course of pregnancy and childbirth.
The sooner treatment is started and the more accurate diagnosis is made, the higher the chances of a successful restoration of visual function.

The main causes of ptosis of the upper eyelid:

Underdeveloped or absent muscles of the eyelid - congenital ptosis

In this case, ptosis is congenital, combined with other eye pathologies. Most often manifested in one eye, but there are exceptions.

neurogenic ptosis

Manifested after suffering diseases associated with neuralgic disorders. On examination, other anomalies in the location of the eyeball and pupil can be detected.

Ptosis after injury

Refer to the "mechanical" reason. Most often, these are household and sports injuries, as well as the ingress of a foreign object into the eyeball. For such reasons, and may appear.

Aponeurotic ptosis

Manifested due to weakening or stretching of the muscles of the upper eyelid. Most often diagnosed in old age.

false ptosis

It can manifest itself when the skin of the eyelids hangs over the eye. False ptosis can be caused by hereditary factors, structural features of the body and be the result of surgical intervention.

Accurate diagnosis is the key to successful treatment.

It is after determining the type and causes of ptosis that we can talk about further measures.

To do this, it is advisable to contact a good ophthalmologist, as well as, if necessary, a neuropathologist and a plastic surgeon. Depending on the severity and causes of such a disease, the type of surgical intervention is selected.

On the video: ptosis in children

Symptoms and Diagnosis in Adults

You can notice ptosis of the upper eyelid on your own, but only a specialist can accurately diagnose and prescribe treatment. For this, an external examination, assessment of the quality of vision and the presence of concomitant diseases are carried out.
Especially important start treatment in time in childhood, when the formation of the eye apparatus is still not completed.

The consequences of non-treatment can be manifested by strabismus, frequent inflammation of the eyes, as well as partial or complete loss of vision.

Symptoms of ptosis of the upper eyelid:

Decreased viewing angle and quality of vision.
Tilt the head back to see objects better (most common in children).
Sharp raising of an eyebrow.
with insufficient eyelid closure.
Inability to blink and move the eye.
Fatigue and decreased concentration.

With a constant load on the second eye (with unilateral ptosis), may have lazy eye symptoms until complete atrophy of its functions.
Along with this disease can develop in children, as well as a sharp drop in the quality of vision.

It should be noted that ptosis is not only a cosmetic defect, but also a serious pathology leading to partial or complete loss of vision, so timely treatment will help protect yourself from this.

On the video: symptoms and treatment of ptosis

Conservative treatment - eyelid correction surgery

Folk methods, special exercises and innovative techniques - all this "does not work" with ptosis of the upper eyelid.

The only possible method of conservative treatment for adults is a temporary fixation or correction of the fold of the skin eyelid with an adhesive plaster.

It is difficult to call it a qualitative elimination of the problem, therefore, with such pathologies, it is mandatory operation recommended. It is also not worth hoping that the disease will go away on its own, because in this case precious time is lost.

Depending on the degree of damage and the causes of the disease, the type of surgical intervention is prescribed.

Price

Average cost of the operation ranges from 15 to 30 thousand rubles. The main advantage of surgery is the complete cure of the patient with a lifetime guarantee of results. What is radical keratotomy will tell.

If we are talking about neurological ptosis, the usual operation is not prescribed until the main ailment is completely cured. If, after the elimination of neurological problems, ptosis has not disappeared, further treatment must be agreed with an ophthalmologist.

Video: gymnastics and exercises, exercises for the eyes

On the video: exercises and gymnastics for ptosis of the upper eyelid

Prevention

It is very difficult to protect yourself from such an ailment, because the causes of the appearance can be very diverse.

Among the main directions, it is possible to note the necessary protection of the eyes when working in harmful conditions, as well as from the ingress of foreign objects.

Parents need to sound the alarm for any anomalies in development, and not patiently wait until they "outgrow". In addition, it is recommended to visit an ophthalmologist at least once a year to identify possible vision problems.
If this is a frequent occurrence in your family, or if there are already existing diseases, the frequency of visits should be increased. In addition, good nutrition and rest are the best tips for the prevention of many diseases, including ptosis. Learn about the causes of nystagmus.

What is ptosis of the upper eyelid?

One of the pathologies of the human body affecting the facial area is ptosis of the upper eyelid. This disease in medical science is called "blepharoptosis". It manifests itself as a drooping of the upper eyelid, covering the palpebral fissure. In addition to the aesthetic problem of changing the appearance of the face, pathology affects the state of human health and may lead to the development of other diseases associated with the quality of vision. These include astigmatism, doubling of the image, amblyopia, as well as a decrease in the threshold of sensitivity of the cornea.

In a healthy person, the upper eyelid normally covers the pupil by no more than one and a half millimeters. If this norm is exceeded or with two open eyes there is an asymmetry of pupil cover, in this case there is a drooping or ptosis of the upper eyelid.

Pathology can be acquired during a person's life, or congenital. In this regard, it occurs both in childhood and in adults.

Symptoms of the disease

It is possible to determine the presence of ptosis of the eyelids by a number of external signs in a patient, which include the following:

slightly closed eyelids of one or both eyes;
"surprised" look (raised eyebrows);
head thrown back (forced posture);
tired sleepy look;
the presence of strabismus;
irritation or inflammation of the eyes (in some cases, it can cause the onset of an infectious process);
split image;
increased eye fatigue;
palpebral fissure does not close completely when blinking.

Characteristic postures for a patient with blepharoptosis are a necessary measure. Throwing back the head and raising the eyebrows occurs due to the impossibility of fully opening the eye.

As a result of the fact that a person cannot blink normally, the eyeball is irritated and inflamed. Weakening of eyelid function can lead to infection.

The nature of the pathology

Congenital pathology occurs in infants as a result of the underdevelopment of certain facial muscles that are responsible for the movement of the upper eyelid, or as some feature of the genetic structure. One of the forms acts as a congenital feature - myasthenic ptosis. It manifests itself in the rapid fatigue of the facial muscles, as a result of which the disease does not manifest itself in a person after waking up, and after a few hours one can observe overhanging of the eyelids and overlapping of the palpebral fissure.

In some patients, myasthenic ptosis manifests itself after exposure to some provoking factors. In this case, the pathology is classified as acquired.

Aponeurotic ptosis also acts as an acquired disease, the occurrence of which is due to stretching or weakening of the facial muscles. It can also appear as a result of aging of the body and a decrease in the elasticity of muscle fibers.

External factors, such as gravitational force, can influence the state of the organism. This is a natural factor that affects all organisms equally. In humans, the influence of gravity can cause the formation of gravitational ptosis. The soft tissues of the facial surface sag and begin to sag under their natural mass, covering the incision of the eyes.

Acquired pathology can act in the neurogenic form of the disease (it manifests itself with lesions of the nerve endings), or traumatic (the upper eyelid may sag as a result of head injury).

Causes of congenital ptosis

The development of congenital pathology most often affects both eyes. Unilateral ptosis of the eyelids in humans develops due to the influence of external factors and is one of the acquired diseases.

The causes of the development of the disease at birth can be:

the presence of autoimmune diseases;
birth injury;
development of an additional fold on the eyelid;
underdevelopment of the eye womb due to genetic characteristics;
manifestation of the Marcus-Gunn phenomenon (involuntary movement of the eyelids during chewing movements);
the development of tumor elements on the facial part, including in the eye area.

Diagnosing the congenital form of the disease can be quite difficult. Babies often blink during feeding, which makes it almost impossible to recognize ptosis.

Causes of Acquired Ptosis

Acquired pathology can be caused by the following factors:

the presence or development of diseases of the central nervous system that cause paralysis of the optic nerves;
natural aging;
the presence of chronic diseases;
mechanical trauma to the head;
medical manipulations on the eye area and the face as a whole (plastic surgery).

Ptosis of the upper eyelid: degrees

The pathological condition of the eyelid can affect one eye, and both at the same time. In this case, it is worth talking about the presence of unilateral or bilateral ptosis.

The manifestation of the disease can be observed in varying degrees, so it is customary to divide the pathology into three stages:

partial covering of the palpebral fissure (when the pupil is covered by no more than 1/3) - the first degree;
incomplete overhanging of the eyelid (palpebral fissure is open within half of the pupil) - the second degree;
complete ptosis of the eyelid (the pupil is completely covered by the upper eyelid) - the third degree.

The presence of the disease in the last stage without timely treatment often leads to a decrease in vision - amblyopia.

Diagnostics

Early diagnosis of any disease allows you to cure it at the initial stage with a minimum number of consequences. A diagnosis of blepharoptosis can only be made by a specialized ophthalmologist. The main task in the diagnosis is to find out the initial causes of the development of pathology.

The doctor conducts a series of studies and measurements:

eyesight check;
measurement of intraocular pressure;
determination of the presence of strabismus;
determination of the muscle strength of the upper eyelid;
measurement of the crease of the upper eyelid;
checking the symmetry of eye mobility;
assessment of the position of the upper eyelid relative to the pupil and its mobility;
eyebrow mobility assessment.

An examination by an ophthalmologist involves taking an anamnesis, where the patient must indicate the availability of all the necessary information regarding past diseases, injuries, operations, as well as the presence of hereditary diseases and blepharoptosis in the older generation of relatives.

Along with other types of the disease, a patient can be diagnosed with false ptosis. This is a form of eyelid drooping, which is observed very often in old age due to a decrease in skin turgor. The resulting skin fold hangs and covers part of the palpebral fissure.

The development of cosmetic procedures leads to the fact that an increasing number of people using "beauty shots" become victims of drooping eyelids. The use of drugs containing botulinum toxin to maintain the beauty and youthfulness of the skin leads to temporary paralysis of tissues. The muscles of the face become motionless and insensitive. This leads to loss of sensation and the upper eyelid.

The effect of such procedures lasts from six to twelve months. The negative effect on the facial muscles can weaken after a certain period of time on their own. Most patients do not wait for spontaneous improvement and seek medical help. During the action of the drugs, visual impairment may occur, strabismus or myopia may develop.

Methods of treatment

Eyelid prolapse can be treated in two ways: conservative and surgical. Conservative therapy is mainly aimed at eliminating the root cause of the disease and restoring the normal functioning of the levator muscle. This is achieved with the help of medicines, physiotherapy and alternative medicine methods.

Non-surgical treatment includes:

local exposure to ultrahigh-frequency therapy - exposure to high-frequency electromagnetic pulses on the cornea of the eye;
drug treatment to restore nervous tissue;
mimic gymnastics for the face;
physiotherapy;
therapeutic local massage;

The use of such techniques brings results only in the case of the development of ptosis of the first degree. The techniques give a positive trend towards normalization of vision, but this effect is not achieved in all cases. If conservative treatment does not bring a positive result, surgical intervention is necessary.

An important point is the treatment of a congenital form of pathology. In childhood, the formation of visual acuity occurs, which will be prevented by a lowered eyelid.

The use of surgical intervention is relevant if, after identifying the cause of the underlying disease and its treatment, there is no positive dynamics.

Surgical treatment of this disease does not require much time. The operation lasts no more than an hour. If the form of the disease is congenital, the levator muscle, which is responsible for the mobility of the eyelid, is cut. If ptosis is acquired, her tendon is shortened. In adults, surgery is performed using local anesthesia. The surgical wound is sutured with a cosmetic suture and heals within a short period of time. A sterile bandage is applied for several hours after the intervention. After complete healing, the seam is almost invisible to others.

Non-traditional methods

Alternative medicine methods in some cases bring quite good results, provided they are used regularly. These include:

daily application of compresses with decoctions of medicinal herbs, grated raw potatoes or parsley;
wiping the upper eyelid area twice a day with an ice cube from a decoction of chamomile or another medicinal plant;
use of cosmetic masks with a lifting effect.

These procedures are especially effective in eliminating false ptosis. In order to prevent age-related changes associated with sagging skin of the upper eyelid, you should choose the right daily care according to your skin type and perform a simple set of gymnastic exercises for the face and eyes.

Gymnastics for the eyes

Good results with regular use are shown by performing gymnastics for the eyes. This is a specially designed set of exercises that helps to get rid of ptosis of the upper eyelid in the first and even second stages after three to six months of regular training.

Exercises are performed in the following sequence:

The gaze is fixed on the object, circular movements of the eyes are slowly made in the direction of the clockwise movement. Repetition 5-7 times.
Look up and open your mouth wide. In this position, frequent blinking is performed for 30 seconds. Time should be gradually increased, adding 10 seconds and bringing up to four minutes.
With closed eyes in a relaxed state, counting to five is carried out, after which the eyes open and the gaze concentrates on the horizon line. Repeat at least 5-7 times.
With the eyes open, slightly stretch the skin in the temple area and blink for thirty seconds.
With the eyes closed, the skin at the outer corners of the eyes is pressed lightly with the fingers. In this position, you must try to open your eyes as wide as possible, overcoming resistance. Repetition 5-7 times.
The head is tilted back and the eyes are closed. In this position, the count is kept up to ten.

This set of exercises helps not only to strengthen the eye and facial muscles, but also improves visual acuity and relieves fatigue during prolonged eye strain, for example, when working at a computer. With regular performance of all exercises, a noticeable effect is visible after three to four weeks.

Self massage

Self-massage is very easy to use and does not require special preparation. It can be performed without outside help at any time - at home or at work. It includes a list of simple manipulations that are very effective in the prevention and treatment of drooping eyelids.

Stages of self-massage:

It is made only with clean hands after the use of cleaning and disinfecting agents.
A drop of fragrance-free massage hypoallergenic oil is applied to the eyelid area (to avoid an allergic reaction). Massage movements are performed from the inner edge to the outer along the upper eyelid and in reverse order - along the lower one for 1.5-2 minutes.
Light tapping movements in the same sequence are performed with fingertips for at least 2-3 minutes.
On the area of the eyelids, when they are completely closed, frequent gentle pressure is applied for two minutes with the fingertips.
After the massage, a compress with a decoction of chamomile is applied to the eyelids.

The effectiveness of self-massage is achieved mainly due to complete relaxation and distraction from extraneous matters. Emotional relaxation is an important factor.